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Armoon B, Griffiths MD, Mohammadi R. The Global Distribution and Epidemiology of Psychoactive Substance Use and Injection Drug Use Among Street-Involved Children and Youth: A Meta-Analysis. Subst Use Misuse 2023; 58:746-764. [PMID: 36924274 DOI: 10.1080/10826084.2023.2181036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background: Globally, street-involved children and youth (SICY) who work and live on/of the streets are at higher risk of increased psychoactive substances and injecting drug use. Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic factors, and risk-taking behaviors associated with psychoactive substances and injecting drug use among SICY. Methods: Studies in English published from December 1 1985 to July 1 2022, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on psychoactive substances and injecting drug use among SICY. The pooled-prevalence estimates were obtained using a robust fixed-effects model. Results: The most commonly reported life-time and current psychoactive substance was tobacco followed by cannabis, LSD/ecstasy, cocaine, methamphetamine, heroin and injection drug use. The results showed that life-time and current prevalence of methamphetamine and cannabis use, as well as life-time prevalence of cocaine, LSD/ecstasy, heroin, tobacco, and injecting drug use increased as age rose while current prevalence of cocaine and tobacco use decreased as age rose. SICY who were male, homeless, had parents who had died, had history of substance use among family members or best friends, had experienced violence, had casual sex partners, had a history of working in the sex trade, and had unprotected sex were all related to psychoactive substance use and injecting drug use. Conclusions: Research examining this population suffers from lack of studies, therefore, improving the knowledge for interventions aimed at reducing risk behaviors, particularly those related to the transmission of sexually transmitted infections such as HIV is of great importance.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
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The Effects of the Inhalant Toluene on Cognitive Function and Behavioral Flexibility: A Review of Recent Findings. ADDICTION NEUROSCIENCE 2023; 5:100059. [PMID: 36798693 PMCID: PMC9928149 DOI: 10.1016/j.addicn.2022.100059] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Substance use disorder (SUD) is characterized, in part, by lack of control over drug seeking and taking. The prefrontal cortex (PFC) is highly involved in control of behavior and deficits in PFC structure and function have been demonstrated in clinical and preclinical studies of SUD. Of the various classes of drugs associated with the development of SUD, inhalants are among the least studied despite their widespread use among adolescents and children. In this work, we review what is currently known regarding the sites and mechanisms of action of inhalants with a focus on the volatile solvent toluene that is contained in a wide variety of legal and easily obtained products. We then describe how inhalants including toluene affect various behaviors with an emphasis on those associated with PFC function and how chronic use of inhalants alters brain structure and neuronal signaling. Findings from these studies highlight advances made in recent years that have expanded our understanding of the effects of inhalants on brain structure and reinforce the need for continued work in this field.
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Berling I, Chiew A, Brown J. Poisonings from hydrocarbon inhalant misuse in Australia. Addiction 2023. [PMID: 36776135 DOI: 10.1111/add.16166] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/19/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND AND AIMS Inhalational misuse of volatile substances has been a significant public health concern because of the risk of sudden death and associated chronic complications such as encephalopathy. The Australian Government released a Consensus-based clinical practice guideline in 2011 on the management of volatile substance use in Australia, which noted a lack of available data particularly on harms. This study aimed to measure (1) the number of calls received by the New South Wales Poisons Information Centre (NSWPIC) regarding inhalational hydrocarbon exposures or poisonings and (2) the number of unintentional deaths reported to the National Coronial Information System (NCIS) in Australia. DESIGN, SETTING, CASES, MEASUREMENTS We performed a retrospective review of all recreational inhalational hydrocarbon exposure calls to the NSWPIC between 1 January 2010 and 31 December 2020. A search was made of the NCIS database in all states and territories over the same period to determine the number of non-intentional inhalational hydrocarbon-related deaths in Australia. FINDINGS Between January 2010 and December 2020, there were 752 primary calls made to the NSWPIC regarding hydrocarbon use or exposure. Age or age bracket was recorded in 748 cases, with 508 (67%) calls involving children or adolescents. Over the same time, there were 58 unintentional deaths involving the recreational use of inhalational hydrocarbons. The median age at death was 23 years (interquartile range = 15-30 years), and 72% (42 cases) were male. Cause of death was predominately acute suffocation/asphyxia, encephalopathy related to chronic use, cardiac arrest likely from sudden sniffing syndrome or thermal injuries secondary to unintentional fires sparked by the volatile agents. CONCLUSION Although death and cardiac arrest are uncommon among people in Australia who misuse hydrocarbons for recreational use, the deaths and cardiac arrests tend to occur in adolescents.
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Affiliation(s)
- Ingrid Berling
- School of Medicine and Public Health, University of Newcastle, University Dr, Callaghan, Newcastle, New South Wales, 2308, Australia.,Department of Emergency Medicine, Calvary Mater Newcastle, Edith St, Waratah, New South Wales, 2298, Australia.,Department of Clinical Toxicology, Prince of Wales Hospital, Randwick, New South Wales, 2031, Australia.,New South Wales Poisons Information Centre, Sydney Children's Hospital, Sydney, New South Wales, 2298, Australia
| | - Angela Chiew
- Department of Clinical Toxicology, Prince of Wales Hospital, Randwick, New South Wales, 2031, Australia.,New South Wales Poisons Information Centre, Sydney Children's Hospital, Sydney, New South Wales, 2298, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, 2052, Australia
| | - Jared Brown
- New South Wales Poisons Information Centre, Sydney Children's Hospital, Sydney, New South Wales, 2298, Australia
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Albals D, Yehya A, Wazaify M. Psychoactive substances use in Jordan: Descriptive study of data from Anti-narcotic Department (AND), 2014-2018. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2021.1941354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Dima Albals
- Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Alaa Yehya
- Department of Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, the University of Jordan, Amman, Jordan
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Demenech LM, Paludo SDS, Silva PDSD, Paiva AMND, Fontes F, Neiva-Silva L. [Sexual exploitation of homeless children and adolescents living on the streets in Southern Brazil]. CIENCIA & SAUDE COLETIVA 2021; 26:5701-5710. [PMID: 34852102 DOI: 10.1590/1413-812320212611.31052020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to investigate the prevalence of sexual exploitation of homeless children and adolescents living on the streets, as well as characteristics associated with this outcome. In this cross-sectional investigation, carried out in the municipalities of Rio Grande and Porto Alegre-RS, data were collected through interviews, which were conducted by trained interviewers. The Respondent-Driven Sampling (RDS) strategy was adopted and statistical analyses were conducted using Poisson regression with robust adjustment of variance. The sample included 186 children and adolescents between 10 and 17 years of age, of which 8% reported having been subjected to sexual exploitation. Being 16 to 17 years old, having had forced sexual intercourse and not having bonds with school were characteristics independently associated with this outcome. It was observed that the lack of contact with school increased the probability 16-fold of having suffered sexual exploitation, being considered the main risk factor in this study. The proposition is that the inclusion and permanence of homeless children and adolescents living on the streets into schools might significantly reduce the risk of sexual exploitation of this population group.
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Affiliation(s)
- Lauro Miranda Demenech
- Centro de Estudos sobre Risco e Saúde (CERIS), Universidade Federal do Rio Grande (FURG). Av. Itália, km 8, Carreiros. 96203-900 Rio Grande RS Brasil. .,Programa de Pós-Graduação em Ciências da Saúde, FURG. Rio Grande RS Brasil
| | | | - Priscilla Dos Santos da Silva
- Centro de Estudos sobre Risco e Saúde (CERIS), Universidade Federal do Rio Grande (FURG). Av. Itália, km 8, Carreiros. 96203-900 Rio Grande RS Brasil.
| | - Alice Monte Negro de Paiva
- Centro de Estudos sobre Risco e Saúde (CERIS), Universidade Federal do Rio Grande (FURG). Av. Itália, km 8, Carreiros. 96203-900 Rio Grande RS Brasil.
| | - Fernanda Fontes
- Centro de Estudos sobre Risco e Saúde (CERIS), Universidade Federal do Rio Grande (FURG). Av. Itália, km 8, Carreiros. 96203-900 Rio Grande RS Brasil.
| | - Lucas Neiva-Silva
- Centro de Estudos sobre Risco e Saúde (CERIS), Universidade Federal do Rio Grande (FURG). Av. Itália, km 8, Carreiros. 96203-900 Rio Grande RS Brasil. .,Programa de Pós-Graduação em Psicologia, FURG. Rio Grande RS Brasil
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Mulu N, Mohammed B, Woldie H, Shitu K. Determinants of stunting and wasting in street children in Northwest Ethiopia: A community-based study. Nutrition 2021; 94:111532. [PMID: 34942423 DOI: 10.1016/j.nut.2021.111532] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/04/2021] [Accepted: 10/23/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to identify determinant factors of stunting and wasting in street children ages 5 to 18 y in Northwest Ethiopia. MATERIALS AND METHODS A community-based cross-sectional study design was employed. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. A convenience sampling technique was used to recruit participants. Stunting and wasting were defined as having a height-for-age and weight-for-height Z score of less than -2 SDs, respectively. Both bivariable and multivariable logistic regression analyses were fitted to identify factors associated with stunting and wasting. A 95% confidence interval (CI) and P < 0.05 were used to declare statistical significance. RESULTS The overall prevalence of stunting and wasting was 46.4% (95% CI: 41.6-51.5%) and 15.3 % (95% CI: 11.7-19.0%), respectively. Age (adjusted odds ratio [AOR] = 0.18, 95% CI: 0.08, 0.47), substance use (AOR = 2.07, 95% CI: 1.33, 3.21), and loss of appetite (AOR = 2.00, 95% CI: 1.31, 3.04) were independently associated with stunting. Whereas age (AOR = 0.49, 95% CI: 0.27, 0.89), illness (AOR = 2.38, 95% CI: 1.27, 4.48), and open defecation (AOR = 2.27, 95% CI: 1.14, 4.51) were factors associated with wasting. CONCLUSION Stunting and wasting were found to be critical problems in street children. Age, loss of appetite, and substance use were significantly associated with stunting, whereas child age, illness, and open defecation practice were significantly associated with wasting. Thus, tailored nutritional interventions are urgently required in this population to improve their nutritional status.
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Affiliation(s)
- Nega Mulu
- Department of Biology, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia
| | - Bekrie Mohammed
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haile Woldie
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Basu G, Biswas S, Pisudde P, Mondal R. Sociodemographic and psychosocial correlates of substance abuse among street children: A cross-sectional survey in the streets of Kolkata, West Bengal. J Family Med Prim Care 2021; 10:2259-2264. [PMID: 34322422 PMCID: PMC8284227 DOI: 10.4103/jfmpc.jfmpc_2449_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/21/2021] [Accepted: 03/17/2021] [Indexed: 11/04/2022] Open
Abstract
Context India is now witnessing steady increase of substance abuse in younger age group. Street life is a major reason in addition to curiosity, unawareness of harm, migration, peer pressure. Aims To assess the prevalence, pattern and related factors of substance use and stress among the street living children. Settings and Design This street-based observational, cross sectional survey included 150 street children living in vicinity of railway stations, business activity centre and major religious places of Kolkata. Methods and Material A descriptive research was done in 150 street children, aged 6 to 18 years and stayed in the street for at least six months. Respondents and care givers were interviewed with pre designed proforma to obtain information on socio demographic attributes, pattern of substance abuse, psycho social issues, self rated health. Weight and height were recorded by calibrated standardized instrument. Statistical analysis used Collected data were analyzed with SPSS 22.0(licensed). Chi-square test or Fisher's exact test was done for normally distributed, skewed and categorical variables respectively. The significance level was set at 5%. Results Two-thirds of participants used substance. Illiteracy was significantly more in females. Perceived positive benefit was commonest reason while feeling happiness and diminished pain was the most common expectation behind substance abuse. Peer group had the biggest influence (92.0%) on their life. Substance abuse was significantly more in males, adolescents, employed, without family attachment, adult as influencer and in those who lived on street without family. Conclusions Higher prevalence of substance abuse among males, adolescents with adult influencer, employed and without family attachment highlighted the urgent need of intervention to see a better future.
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Affiliation(s)
- Gandhari Basu
- Department of Community Medicine, College of Medicine and JNM Hospital, West Bengal University of Health Sciences, Kolkata, West Bengal, India
| | - Saumyadeep Biswas
- Final Year MBBS Student, College of Medicine and JNM Hospital, West Bengal University of Health Sciences, Kolkata, West Bengal, India
| | - Pravin Pisudde
- Department of Community Medicine, ESIC Medical College, Sanath Nagar, Hyderabad, Telangana, India
| | - Reshmi Mondal
- Department of Community Medicine, College of Medicine and JNM Hospital, West Bengal University of Health Sciences, Kolkata, West Bengal, India
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Attia MS, Tayel KY, Shata ZN, Othman SS. Psychosocial profile of institutionalised street children in Alexandria, Egypt: a comparative study with school children. J Child Adolesc Ment Health 2017; 29:103-116. [PMID: 28974166 DOI: 10.2989/17280583.2017.1339606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The phenomenon of street children in Egypt constitutes a public health concern. This study aimed to investigate the characteristics of institutionalised street children in Alexandria, to compare the prevalence of substance abuse and conduct disorder between street children and school children, and to identify predictors of these mental health outcomes among street children. METHODS Institutionalised street children (n = 102) participated in a cross-sectional comparative study with a matched group of school children (n = 156). An interviewing questionnaire was used to assess demographic characteristics and substance use. Conduct disorder was measured using the Revised Ontario Child Health study scale. RESULTS Poverty, family breakdown, and domestic violence were the main reasons for street children having left home. Street children recorded significantly higher rates of substance use (9.8%) and conduct disorder (35.3%) compared to school children. In street children, smoking was a significant predictor of substance use and conduct disorder. Other predictors of conduct disorder included physical illness and having 5 to 7 siblings. CONCLUSION Substance abuse and conduct disorder were present among institutionalised street children at higher rates than school children. Absence of basic life needs and disrupted families constituted the main reasons for leaving home. Interventions at the governmental and non-governmental levels are needed.
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Affiliation(s)
- Medhat S Attia
- a Mental Health, Family Health Department, High Institute of Public Health , Alexandria University , Alexandria , Egypt
| | - Kholoud Y Tayel
- b Adolescent and School Health, Family Health Department, High Institute of Public Health , Alexandria University , Alexandria , Egypt
| | - Zeinab N Shata
- a Mental Health, Family Health Department, High Institute of Public Health , Alexandria University , Alexandria , Egypt
| | - Sally S Othman
- a Mental Health, Family Health Department, High Institute of Public Health , Alexandria University , Alexandria , Egypt
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9
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d'Abbs P, Shaw G, Field E. The impact of subsidized low aromatic fuel (LAF) on petrol (gasoline) sniffing in remote Australian indigenous communities. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2017; 12:38. [PMID: 28818114 PMCID: PMC5561594 DOI: 10.1186/s13011-017-0121-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/06/2017] [Indexed: 11/16/2022]
Abstract
Background Since 2005, the Australian Government has subsidized the production and distribution of Low Aromatic Fuel (LAF) as a deterrent against petrol (gasoline) sniffing in remote Indigenous communities. LAF is used in place of unleaded petrol as a fuel for vehicles and other engines. This paper reports findings from an independent evaluation of the LAF rollout. Methods Forty one Indigenous communities were surveyed between 2010 and 2014, with each community being visited twice at a two yearly interval. Quantitative data on prevalence of petrol sniffing were collected, as well as qualitative data on the acceptability of LAF, evidence of substitution for inhaled petrol with other drugs, and programs such as recreational, training and employment opportunities. Prevalence rates of sniffing per 1000 population for each survey year and community were calculated by dividing the total number of sniffers by the population aged 5–39 years and multiplying by 1000. Results Between 2011–12 and 2013–14, the total estimated number of people sniffing petrol declined from 289 to 204, a fall of 29.4%. At both times, the median petrol sniffing prevalence rate was lower in communities with LAF than in communities without LAF. In 17 of the 41 communities, comparable data were available over a longer period, commencing in 2005–06. Fifteen of these communities stocked LAF over the entire period. In these communities, the median rate of petrol sniffing declined by 96%, from 141.6 per 1000 population in 2005–06 to 5.5 in 2013–14 (p < 0.05). LAF was widely accepted, although acceptance was often qualified by a belief that LAF harmed engines. Anecdotal reports suggest that the fall in petrol sniffing may have been offset by increased use of cannabis and other drugs, but the relationship is not one of simple cause-and-effect, with evidence that an increase in cannabis use in communities commenced before the LAF rollout began. Provision of services in communities has improved in recent years, but many programs continue to be inadequately resourced. Conclusions The rollout of LAF appears to have contributed to reducing petrol sniffing and associated harms in Australian Indigenous communities.
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Affiliation(s)
- Peter d'Abbs
- Menzies School of Health Research, Brisbane, Australia. Peter.d'.,School of Public Health, University of Queensland, Brisbane, Australia. Peter.d'
| | | | - Emma Field
- Menzies School of Health Research, Brisbane, Australia
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10
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Abstract
Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan.
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Affiliation(s)
- Michael Storck
- Department of Child Psychiatry, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA.
| | - Laura Black
- New York University, Department of Psychiatry, One Park Avenue, 8 th floor, New York, NY 10016, USA
| | - Morgan Liddell
- Department of Child Psychiatry, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA
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11
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Elayeh E, Bulatova N, Basheti I, Abu Farha R, Al-Rawi N, Abu Snaineh A, Alahwal I. The use and safety of medications known to affect driving in Jordan: A cross-sectional study. TRAFFIC INJURY PREVENTION 2015; 17:238-244. [PMID: 26421446 DOI: 10.1080/15389588.2015.1065543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 06/20/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The aim of this study was to estimate the main driving-impairing medications used by drivers in Jordan, the reported frequency of medication side effects, the frequency of motor vehicle crashes (MVCs) while using driving-impairing medicines, as well as factors associated with MVCs. METHODS A cross-sectional study involving 1,049 individuals (age 18-75 years) who are actively driving vehicles and taking at least one medication known to affect driving (anxiolytics, antidepressants, hypnotics, antiepileptics, opioids, sedating antihistamines, hypoglycemic agents, antihypertensives, central nervous system [CNS] stimulants, and herbals with CNS-related effects) was conducted in Amman, Jordan, over a period of 8 months (September 2013-May 2014) using a structured validated questionnaire. RESULTS Sixty-three percent of participants noticed a link between a medicine taken and feeling sleepy and 57% stated that they experience at least one adverse effect other than sleepiness from their medication. About 22% of the participants reported having a MVC while on medication. Multiple logistic regression analysis showed that among the participants who reported having a crash while taking a driving-impairing medication, the odds ratios were significantly higher for the use of inhalant substance (odds ratio [OR] = 2.787, P = .014), having chronic conditions (OR = 1.869, P = .001), and use of antiepileptic medications (OR = 2.348, P = .008) and significantly lower for the use of antihypertensives (OR = 0.533, P = .008). CONCLUSION The study results show high prevalence of adverse effects of medications with potential for driving impairment, including involvement in MVCs. Our findings highlight the types of patient-related and medication-related factors associated with MVCs in Jordan, such as inhalant use, presence of chronic conditions, and use of antiepileptics.
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Affiliation(s)
- Eman Elayeh
- a Department of Biopharmaceutics and Clinical Pharmacy , Faculty of Pharmacy, the University of Jordan , Amman , Jordan
| | - Nailya Bulatova
- a Department of Biopharmaceutics and Clinical Pharmacy , Faculty of Pharmacy, the University of Jordan , Amman , Jordan
| | - Iman Basheti
- b Department of Clinical Pharmacy , Faculty of Pharmacy, Applied Science University , Amman , Jordan
| | - Rana Abu Farha
- a Department of Biopharmaceutics and Clinical Pharmacy , Faculty of Pharmacy, the University of Jordan , Amman , Jordan
| | - Naseer Al-Rawi
- c Department of Pharmaceutical Sciences , Faculty of Pharmacy and Medical Sciences, Al-Ahliyya Amman University , Amman , Jordan
| | - Ahmad Abu Snaineh
- a Department of Biopharmaceutics and Clinical Pharmacy , Faculty of Pharmacy, the University of Jordan , Amman , Jordan
| | - Ibrahim Alahwal
- a Department of Biopharmaceutics and Clinical Pharmacy , Faculty of Pharmacy, the University of Jordan , Amman , Jordan
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Cumber SN, Tsoka-Gwegweni JM. The Health Profile of Street Children in Africa: A Literature Review. J Public Health Afr 2015; 6:566. [PMID: 28299148 PMCID: PMC5349275 DOI: 10.4081/jphia.2015.566] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 07/13/2015] [Indexed: 11/22/2022] Open
Abstract
The United Nations Children's Fund has labeled street children as children in difficult circumstances, which represent a minority population that has been under-represented for too long in health research. This is a concern because street children are at risk of carrying a greater disease burden. Their homeless lifestyle makes them more vulnerable to health risks and problems than children who live at home; as they roam the streets begging for food and money to obtain basic needs and are found sleeping in half-destroyed houses, abandoned basements, under bridges and in the open air. This paper presents health results from a systematic review of literature from 17 databases and including 16 countries in Africa. The review revealed that there are more boys than girls living on the street in their adolescence and who mainly have left home due to poverty and abuse. These children in these countries are vulnerable to poor health due to factors such as homelessness, risky sexual behavior, substance abuse and violence. Among the health problems identified are growth and nutritional disorders, physical injuries, violence, sexual abuse, communicable diseases including diarrheal diseases, malaria, respiratory diseases, neglected tropical diseases, mental health issues, substance abuse, reproductive health disorders, mortality, sexually transmitted diseases and HIV/AIDS. Primary interventions that could prevent poor health and improve the health status of street children include provision of safe shelter, proper nutrition, access to health care, health education, and sexual reproductive health, protection from any form of abuse, violence and substance abuse. Enforcing state policies and laws in all African countries is required to protect street children from neglect, abuse and to increase their access to education. More research on the health risks and health status of street children is still required, particularly in Sub-Saharan Africa, which carries the greatest disease burden and poverty.
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Affiliation(s)
- Samuel Nambile Cumber
- Discipline of Public Health Medicine, Department of Nursing and Public Health, College of Health Sciences, University of Kwazulu-Natal Durban, South Africa
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Loffredo CA, Boulos DNK, Saleh DA, Jillson IA, Garas M, Loza N, Samuel P, Shaker YE, Ostrowski MJ, Amr S. Substance use by Egyptian youth: current patterns and potential avenues for prevention. Subst Use Misuse 2015; 50:609-18. [PMID: 25629955 DOI: 10.3109/10826084.2014.997391] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Substance abuse in Egypt is a serious public health threat. Recent studies have demonstrated increases in the prevalence of the use of tobacco, illegal drugs, and over-the-counter drugs, particularly among youth. METHODS We conducted focus groups with a total of 40 male and female youth participants, ages 12-14 and 15-18, recruited from two different areas (Cairo and Alexandria) in 2012. We investigated their knowledge and perceptions regarding current substance use, its sources, and promoting and protecting factors, broadly addressing the use of tobacco products, illicit and prescription drugs, inhaled substances such as glue and solvents, and alcohol. RESULTS Our findings suggest that: (1) youth in Egypt had access to and were actively using substances encountered in similar research worldwide, including tobacco, alcohol, illicit drugs, glue sniffing, and pharmaceutical agents; (2) smoking cigarettes and using hashish were the most common practices, and Tramadol was the most commonly used pharmaceutical drug; (3) peer pressure from friends stood out as the most common reason to start and continue using substances, followed by adverse life events and having a parent or family member who used substances; (4) strict parenting, religiosity, and having non-user friends were among the factors perceived by youth to prevent substance use or help them quit using substances; (5) most youths were aware of the adverse health effects of substance use. CONCLUSION These findings will inform the design of quantitative surveys aimed at estimating the prevalence of specific behaviors related to substance use among youth and potential avenues for prevention.
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Oppong Asante K, Meyer-Weitz A, Petersen I. Substance use and risky sexual behaviours among street connected children and youth in Accra, Ghana. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2014; 9:45. [PMID: 25428774 PMCID: PMC4258041 DOI: 10.1186/1747-597x-9-45] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 11/16/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Research on street children and youth has shown that this population is at high risk for substance use. Though risky sexual behaviours have been investigated and widely reported among street youth in resource constrained-settings, few studies have explored the relationship between substance use and other risk behaviours. This study was therefore conducted to examine the association between substance use and risky sexual behaviours among homeless youth in Ghana. METHOD A cross-sectional survey of a convenient sample of 227 (122 male and 105 female) street connected children and youth was conducted in Ghana in 2012. Using self-report measures, the relationship between substance use and risky sexual behaviours was examined using logistic regression. RESULTS Substance use was relatively high as 12% and 16.2% reported daily use of alcohol and marijuana respectively. There were age and sex differences in substance use among the sample. As compared to males, more females had smoked cigarettes, used alcohol and marijuana. While alcohol use decrease with age, marijuana use on the other hand increases with age. Results from multivariate analysis revealed that having ever drunk alcohol and alcohol use in the past one month were independently associated with all the four indices of risky sexual behaviour (ever had sex, non-condom use, multiple sexual partners and survival sex). Both marijuana use and smoking of cigarettes were associated with having ever had sex, multiple sexual partners and survival sex. Other drug use was independently associated with non-condom use. CONCLUSION Substance use seems to serve as a possible risk factor for sexual risk behaviours among homeless youth. Harm reduction interventions are needed to prevent street children and youth from engaging in substance use and risky sexual behaviours. Such programmes should pay special attention to females and younger children who are highly susceptible to the adverse conditions on the street.
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Affiliation(s)
- Kwaku Oppong Asante
- Discipline of Psychology, School of Applied Human Sciences, University of KwaZulu-Natal, Howard College Campus, Durban 4041, South Africa.
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Islam F, Kar S, Debroy A, Sarma R. Substance Abuse amongst the Street-children in Guwahati City, Assam. Ann Med Health Sci Res 2014; 4:S233-8. [PMID: 25364595 PMCID: PMC4212383 DOI: 10.4103/2141-9248.141965] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The nature of continuous exposure to the street and its associated life-styles make street children vulnerable to the use of psychoactive substances. AIMS The aim of the present study is to study some social factors of street children in Guwahati city and to ascertain the substance use behavior of the street children. SUBJECTS AND METHODS A population based cross-sectional study conducted during September 2008 to August 2009 among 215 street children between the ages of 5 and 18 years of Guwahati City Assam. The main outcome measures were substance use and its related risk factors prevalent among street children. The data collected were analyzed in Microsoft Office and percentages and Chi-square tests were used to analyze the variables. RESULTS Around 174/215 (80.9%) of study participants were substance abusers. It is noteworthy that as the age increases substance use was more common when compared to younger age group. The risk of substance abuse was 1.26 times relatively higher among those who had never been to school and 1.12 times more common in those from a joint family when compared to others. However the correlations were not found to be statistically significant. Substance abuse was 1.19 times more common in case of deaths of both parents and the association was found to be statistically significant (P = 0.02). Presence of step parents and substance use in the family was seen to be a risk factor for substance abuse and the association was highly significant (P < 0.001). The association of substance abuse with duration of street life was found to be highly significant. Majority of the substance users 152/174 (87.4%) were in the habit of sniffing glue and this was followed by smoking 147/174 (84.5%). CONCLUSION Substance abuse is an important concern affecting street children. Street and its associated life-styles make street children vulnerable to the use of psychoactive substances. Non- government organizations and Government should come forward to curb this problem and save millions of vulnerable lives.
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Affiliation(s)
- F Islam
- Department of Community Medicine, Mata Gurji Memorial Medical College, Kishanganj, Bihar, India
| | - S Kar
- Department of Community Medicine, Sikkim-Manipal Institute of Medical Sciences, Gangtok, Sikkim, India
| | - A Debroy
- Coordinator, Immunization Technical Support Unit, Public Health Foundation of India, New Delhi, India
| | - R Sarma
- Department of Community Medicine, Assam Medical College, Dibrugarh, Assam, India
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Sweileh WM, Zyoud SH, Al-Jabi SW, Sawalha AF. Substance use disorders in Arab countries: research activity and bibliometric analysis. Subst Abuse Treat Prev Policy 2014; 9:33. [PMID: 25148888 PMCID: PMC4144697 DOI: 10.1186/1747-597x-9-33] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/18/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Substance use disorders, which include substance abuse and substance dependence, are present in all regions of the world including Middle Eastern Arab countries. Bibliometric analysis is an increasingly used tool for research assessment. The main objective of this study was to assess research productivity in the field of substance use disorders in Arab countries using bibliometric indicators. METHODOLOGY Original or review research articles authored or co-authored by investigators from Arab countries about substance use disorders during the period 1900-2013 were retrieved using the ISI Web of Science database. Research activity was assessed by analyzing the annual research productivity, contribution of each Arab country, names of journals, citations, and types of abused substances. RESULTS Four hundred and thirteen documents in substance use disorders were retrieved. Annual research productivity was low but showed a significant increase in the last few years. In terms of quantity, Kingdom of Saudi Arabia (83 documents) ranked first in research about substance use disorders while Lebanon (17.4 documents per million) ranked first in terms of number of documents published per million inhabitants. Retrieved documents were found in different journal titles and categories, mostly in Drug and Alcohol Dependence Journal. Authors from USA appeared in 117 documents published by investigators from Arab countries. Citation analysis of retrieved documents showed that the average citation per document was 10.76 and the h - index was 35. The majority of retrieved documents were about tobacco and smoking (175 documents) field while alcohol consumption and abuse research was the least with 69 documents. CONCLUSION The results obtained suggest that research in this field was largely neglected in the past. However, recent research interest was observed. Research output on tobacco and smoking was relatively high compared to other substances of abuse like illicit drugs and medicinal agents. Governmental funding for academics and mental health graduate programs to do research in the field of substance use disorders is highly recommended.
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Affiliation(s)
- Waleed M Sweileh
- Department of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sa’ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ansam F Sawalha
- Department of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Stefanovics EA, Filho MVM, Rosenheck RA, Scivoletto S. Functional outcomes of maltreated children and adolescents in a community-based rehabilitation program in Brazil: six-month improvement and baseline predictors. CHILD ABUSE & NEGLECT 2014; 38:1231-1237. [PMID: 24300697 DOI: 10.1016/j.chiabu.2013.10.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 10/24/2013] [Accepted: 10/30/2013] [Indexed: 06/02/2023]
Abstract
This study sought to implement outcomes monitoring and to review outcome data from a community-based rehabilitation program for maltreated children and adolescents in São Paulo, Brazil. Maltreated children and adolescents (N=452) were enrolled in The Equilibrium Program (TEP), a multidisciplinary community-based rehabilitation program. About half (n=230) of the participants were successfully evaluated using the Children's Global Assessment Scale (C-GAS) at entry, 3, and/or 6 months later. Analysis of outcomes used hierarchical linear modeling of functional change from baseline. With a baseline C-GAS score of 51.7 (SD=14.22), average improvement was 2.8 and 5.5 points at 3 and 6 months, respectively (reflecting small to moderate effect sizes=0.20 and 0.39). Improvement was associated with Problems related to upbringing (p<.02) at entry and absence of Physical abuse (p<.05) and Negative life events in childhood (p<.05) but was not associated with sociodemographics or any specific psychiatric diagnosis. This study showed that outcomes monitoring is feasible in a community-based program in a developing country. Although there was no untreated control group for comparison and specific evidence-based treatments were not used, it is notable that significant improvement, with small to moderate effect size, was observed.
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Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; VA New England Mental Illness Research, Education and Clinical Center, Connecticut Healthcare System, West Haven, CT, USA
| | - Mauro V M Filho
- The Equilibrim Program (TEP), Department and Institute of Psychiatry, Medicine School, University of São Paulo (USP), R.Ovidio Campos Pieres Campos, 785, São Paulo, Brazil
| | - Robert A Rosenheck
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; VA New England Mental Illness Research, Education and Clinical Center, Connecticut Healthcare System, West Haven, CT, USA
| | - Sandra Scivoletto
- The Equilibrim Program (TEP), Department and Institute of Psychiatry, Medicine School, University of São Paulo (USP), R.Ovidio Campos Pieres Campos, 785, São Paulo, Brazil
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Tracy ME, Slavova-Hernandez GG, Shelton KL. Assessment of reinforcement enhancing effects of toluene vapor and nitrous oxide in intracranial self-stimulation. Psychopharmacology (Berl) 2014; 231:1339-50. [PMID: 24186077 PMCID: PMC3954938 DOI: 10.1007/s00213-013-3327-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 10/08/2013] [Indexed: 11/29/2022]
Abstract
RATIONALE Despite widespread abuse, there are few validated methods to study the rewarding effects of inhalants. One model that may have utility for this purpose is intracranial self-stimulation (ICSS). OBJECTIVES This study aims to compare and contrast the ICSS reward-facilitating effects of abused inhalants to other classes of abused drugs. Compounds were examined using two different ICSS procedures in mice to determine the generality of each drug's effects on ICSS and the sensitivity of the procedures. METHODS Male C57BL/6J mice with electrodes implanted in the medial forebrain bundle were trained under a three-component rate-frequency as well as a progressive ratio (PR) ICSS procedure. The effects of nitrous oxide, toluene vapor, cocaine, and diazepam on ICSS were then examined. RESULTS Concentrations of 1,360-2,900 parts per million (ppm) inhaled toluene vapor significantly facilitated ICSS in the rate-frequency procedure and 1,360 ppm increased PR breakpoint. A concentration of 40 % nitrous oxide facilitated ICSS in the rate-frequency procedure but reduced PR breakpoint. Doses of 3-18 mg/kg cocaine facilitated ICSS in the rate-frequency procedure, and 10 and 18 mg/kg increased PR breakpoint. Doses of 1 and 3 mg/kg diazepam facilitated ICSS in the rate-frequency procedure, and 3 mg/kg increased PR breakpoint. CONCLUSIONS The reinforcement-facilitating effect of toluene in ICSS is at least as great as diazepam. By contrast, nitrous oxide weakly enhances ICSS in only the rate-frequency procedure. The data suggest that the rate-frequency procedure may be more sensitive than the PR schedule to the reward-facilitating effects of abused inhalants.
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Affiliation(s)
- Matthew E. Tracy
- Virginia Commonwealth University School of Medicine Department of Pharmacology and Toxicology 410 North 12th Street, Room 746D Richmond, Virginia 23298-0613
| | - Galina G. Slavova-Hernandez
- Virginia Commonwealth University School of Medicine Department of Pharmacology and Toxicology 410 North 12th Street, Room 746D Richmond, Virginia 23298-0613
| | - Keith L. Shelton
- Virginia Commonwealth University School of Medicine Department of Pharmacology and Toxicology 410 North 12th Street, Room 746D Richmond, Virginia 23298-0613,Corresponding Author Keith L Shelton, Ph.D. Phone: 804-827-2104 Fax: 804-828-2117
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Embleton L, Mwangi A, Vreeman R, Ayuku D, Braitstein P. The epidemiology of substance use among street children in resource-constrained settings: a systematic review and meta-analysis. Addiction 2013; 108:1722-33. [PMID: 23844822 PMCID: PMC3776018 DOI: 10.1111/add.12252] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 01/11/2013] [Accepted: 05/13/2013] [Indexed: 11/30/2022]
Abstract
AIMS To compile and analyze critically the literature published on street children and substance use in resource-constrained settings. METHODS We searched the literature systematically and used meta-analytical procedures to synthesize literature that met the review's inclusion criteria. Pooled-prevalence estimates and 95% confidence intervals (CI) were calculated using the random-effects model for life-time substance use by geographical region as well as by type of substance used. RESULTS Fifty studies from 22 countries were included into the review. Meta-analysis of combined life-time substance use from 27 studies yielded an overall drug use pooled-prevalence estimate of 60% (95% CI = 51-69%). Studies from 14 countries contributed to an overall pooled prevalence for street children's reported inhalant use of 47% (95% CI = 36-58%). This review reveals significant gaps in the literature, including a dearth of data on physical and mental health outcomes, HIV and mortality in association with street children's substance use. CONCLUSIONS Street children from resource-constrained settings reported high life-time substance use. Inhalants are the predominant substances used, followed by tobacco, alcohol and marijuana.
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Affiliation(s)
- Lonnie Embleton
- College of Health Sciences, Department of Medicine, Moi University, Eldoret, Kenya
| | - Ann Mwangi
- College of Health Sciences, School of Medicine, Department of Behavioral Sciences, Moi University, Eldoret, Kenya
| | - Rachel Vreeman
- College of Health Sciences, School of Medicine, Department of Pediatrics, Moi University, Eldoret, Kenya
- School of Medicine, Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - David Ayuku
- College of Health Sciences, School of Medicine, Department of Behavioral Sciences, Moi University, Eldoret, Kenya
| | - Paula Braitstein
- College of Health Sciences, Department of Medicine, Moi University, Eldoret, Kenya
- School of Medicine, Department of Medicine, Indiana University, Indianapolis, IN, USA
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada and
- Regenstrief Institute, Inc., Indianapolis, IN, USA
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Woan J, Lin J, Auerswald C. The health status of street children and youth in low- and middle-income countries: a systematic review of the literature. J Adolesc Health 2013; 53:314-321.e12. [PMID: 23706729 DOI: 10.1016/j.jadohealth.2013.03.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 02/06/2013] [Accepted: 03/14/2013] [Indexed: 10/26/2022]
Abstract
The health of the tens of millions of street children globally is understudied. We undertook a systematic review of the existing quantitative literature regarding the health status of street children and youth in low- and middle-income countries to summarize available knowledge, identify underexplored areas of research, and inform the future research agenda regarding the health of this population. A total of 108 articles met our inclusion criteria. Demographic data and structural factors associated with street life are summarized. Although data in specific regions or diseases are sparse, the literature review illustrates that youth's survival behaviors and the exposures associated with poor shelter have resulted in disproportionate morbidity in the areas of infectious illness, psychiatric disease, reproductive health, and perhaps to a lesser extent, growth. Vast areas of health that may disproportionately affect street children in childhood or later on as adults have not been investigated, including chronic diseases and cognitive deficits. Studies of specific diseases or conditions vary considerably by region. Strengths and limitations of the literature are discussed and principles for future research in this area are proposed.
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Affiliation(s)
- Jessica Woan
- University of Washington School of Medicine, Seattle, WA, USA
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Embleton L, Atwoli L, Ayuku D, Braitstein P. The journey of addiction: barriers to and facilitators of drug use cessation among street children and youths in Western Kenya. PLoS One 2013; 8:e53435. [PMID: 23326428 PMCID: PMC3541137 DOI: 10.1371/journal.pone.0053435] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 11/28/2012] [Indexed: 11/19/2022] Open
Abstract
This mixed-methods study examined barriers to and facilitators of street children’s drug use cessation in Eldoret, Kenya utilizing a cross-sectional survey and focus group discussions with a community-based sample of street-involved children and youth. The primary objective of this study was to describe factors that may assist or impede cessation of drug use that can be utilized in developing substance use interventions for this marginalized population. In 2011, 146 children and youth ages 10–19 years, classified as either children on the street or children of the street were recruited to participate in the cross-sectional survey. Of the 146 children that participated in the survey 40 were invited to participate in focus group discussion; 30 returned voluntarily to participate in the discussions. Several themes were derived from children’s narratives that described the barriers to and facilitators of drug cessation. Specifically, our findings reveal the strength of the addiction to inhalants, the dual role that peers and family play in substance use, and how the social, cultural, and economic context influence or impede cessation. Our findings demonstrate the need to integrate community, family and peers into any intervention in addition to traditional medical and psychological models for treatment of substance use dependence.
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Affiliation(s)
- Lonnie Embleton
- Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
| | - Lukoye Atwoli
- Department of Mental Health, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
| | - David Ayuku
- Department of Behavioral Sciences, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
| | - Paula Braitstein
- Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, United States of America
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Regenstrief Institute, Inc., Indianapolis, Indiana, United States of America
- * E-mail:
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Volatile substance misuse : clinical considerations, neuropsychopharmacology and potential role of pharmacotherapy in management. CNS Drugs 2012; 26:927-35. [PMID: 23018545 DOI: 10.1007/s40263-012-0001-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Volatile substance misuse is among the most prevalent and toxic forms of psychoactive drug use, and often results in highly deleterious social, psychological and medical consequences. The prevalence of this pernicious form of substance misuse owes in part to the fact that volatile substances of misuse are ubiquitous in the natural environment. Commonly misused commercial products include glue, shoe polish, nail polish remover, butane lighter fluid, gasoline and computer duster spray. National samples of volatile substance misusers tend to exhibit high rates of psychiatric problems and antisocial behaviour. In addition, cognitive impairments and affective dysregulation are often observed among these individuals. Volatile substances exert their complex neuropharmacological effects on dopaminergic, glutamatergic, GABAergic and serotoninergic receptor systems, as well as on cell membranes and ion channels. Concomitantly, pharmacotherapies for volatile substance abuse might profitably target a number of mechanisms, including reward circuitry in the brain, symptoms of craving and withdrawal, neuropsychiatric and emotional impairments that promote volatile substance abuse, and cognitive enhancement to rectify deficits in executive function. This review details the modes of use, subjective effects, epidemiology, adverse consequences, neuropsychopharmacology and drug treatment of volatile substance misuse, and discusses the potential role of novel forms of pharmacological intervention for this oft-overlooked public health threat of epidemic proportions.
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Embleton L, Ayuku D, Atwoli L, Vreeman R, Braitstein P. Knowledge, attitudes, and substance use practices among street children in Western Kenya. Subst Use Misuse 2012; 47:1234-47. [PMID: 22780841 PMCID: PMC3749375 DOI: 10.3109/10826084.2012.700678] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study describes the knowledge of and attitudes toward substance use among street-involved youth in Kenya, and how they relate to their substance use practices. In 2011, 146 children and youth ages 10-19 years, classified as either children on the street or children of the street were recruited to participate in a cross-sectional survey in Eldoret, Kenya. Bivariate analysis using χ² or Fisher's Exact Test was used to test the associations between variables, and multiple logistic regression analysis was used to identify independent covariates associated with lifetime and current drug use. The study's limitations and source of funding are noted.
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Affiliation(s)
- Lonnie Embleton
- Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
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Abstract
This special issue of Substance Use & Misuse addresses the public health issue of volatile substance misuse (VSM), the inhalation of gases or vapors for psychoactive effects, assessing the similarities and differences in the products misused, patterns, prevalence, etiologies, and impacts of VSM by examining it through sociocultural epidemiology, neuroscience, and interventions research. The Canadian, US, and Australian guest editors contend that, when compared with other drugs used at a similar prevalence, VSM has attracted relatively little research effort. The authors and editors call for further research to develop evidence-based policies and comprehensive interventions that respect culture and context-specific knowledge.
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Affiliation(s)
- Colleen Anne Dell
- Department of Sociology & School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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